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Nausea and Vomiting of Pregnancy

by in Kitchen Sink, Pregnancy February 21, 2008

PhotobucketNausea and vomiting are the most common symptoms experienced in early pregnancy.

Nausea affects between 70-85% of women and vomiting affects approximately 50% of women. Although nausea of pregnancy has commonly been referred to as morning sickness, it can actually occur morning, noon, night, or all day long.

Typically, nausea and vomiting of pregnancy starts by 4-6 weeks gestation, peaks at 8-12 weeks and resolves around the 20th week. However, some women experience nausea and/or vomiting throughout their entire pregnancy.

WHY DOES IT OCCUR?

It is not understood why some women experience nausea and/or vomiting during pregnancy, but hormones appear to be involved. Women with high levels of pregnancy hormones tend to develop the symptoms. It is also more common among women who are pregnant with more than one baby.

WILL NAUSEA AND VOMITING HURT MY BABY?

Nausea and vomiting rarely interferes with proper nutrition enough to harm the developing fetus. It may help to know that the high levels of pregnancy hormones that contribute to nausea also suggest a well-implanted embryo. In fact, statistics show that the more nausea a mother has, the more likely she is to deliver a healthy baby. This does not mean, however, that if you don’t feel sick, you won’t have a good outcome. Many mothers coast through pregnancy with a minimum of nausea and have healthy babies.

Less than 1% of pregnant women suffer a severe form of persistent vomiting called hyperemesis gravidarum. In this condition, the body is unable to compensate for the relentless vomiting and the mother becomes dehydrated. If untreated, this severe vomiting can make a woman very sick, which may, in turn, compromise the health of the baby. The following are signs of dehydration. You should call your doctor or midwife if you are experiencing these symptoms:

• The vomiting is not getting better.
• You’re urinating less and your urine appears darker in color.
• Your mouth, eyes, and skin are feeling dry.
• You are feeling increasingly tired, weak and faint.
• You haven’t been able to keep any food or drink down for 24 hours.

RELIEF MEASURES

There are many remedies for nausea and vomiting of pregnancy and it may require some persistence to find what works for you.

• Keep a journal of daily activities and symptoms to help uncover potential triggers (certain foods, smells, etc.) and things that seem to help alleviate the symptoms (sleep, foods, outdoors, etc).
• Eat something before bed and throughout the night when you wake (crackers, dried cereal).
• Start your day by giving yourself time to ease into your day. Sudden transitions often trigger nausea. If you don’t have to awaken at a set time, don’t use an alarm clock or if you must, try awakening to soothing music. If possible, begin your day with a peaceful, enjoyable activity, such as reading, walking, or meditating.
• Snack on nutritious food throughout the day rather than eating only three meals. Six smaller meals are more digestible than 3 large meals. Try this even if you don’t feel like eating at all.
• Try stomach-friendly, comfort foods: smoothies, potatoes, watermelon, rice cakes, grapes, avocado, pickles, applesauce, sorbet, celery or carrot sticks, oatmeal, breads and whole grains.
• Avoid hard-to-digest fried, high fat, spicy foods. Some women also are bothered by onions, sauerkraut, garlic, cabbage, and caffeine-containing beverages such as coffee.
• Try to eat foods that stimulate your liver, which metabolizes the excess hormones. These include green leafy vegetables, beets, artichoke, lemon, and grapefruit. Eat organic foods when possible.
• Make yourself eat even when you don’t want to eat or drink anything. You are likely to feel worse if you don’t eat or drink something due to low blood sugar that can trigger nausea.
• Herbs such as: ginger – available in many forms (fresh, root extract, ground, capsules, tea, crystals, or pickled), mint, chamomile, and red raspberry can be helpful.
• Minimize stress. Stress has been shown to exacerbate nausea of pregnancy.
• Sleep. Pregnant women require more rest (additional 2 hours sleep/night).
• Dress comfortably and wear loose clothing.
• Studies show that wrist acupressure bands, available at pharmacies and marine stores, are effective in reducing nausea in some pregnant women.
• Go outdoors. A change of scenery, some fresh air, even visiting friends or going to a movie may provide a stomach-settling distraction.
• See your doctor or midwife for more information.

Resources
1. Burrow and Duffy Medical Complications in Pregnancy (5th ed). W.B. Saunders Company, Philadelphia, PA 1999.
2. Frye, A Holistic Midwifery: A Comprehensive Textbook for Midwives in Homebirth Practice, Vol.1: Care During Pregnancy (6th ed). Labrys Press, Portland, OR 1998.
3. Jewell D, Young D Interventions for nausea and vomiting in early pregnancy (Cochrane Review). In: The Cochrane Library, Issue 4, 2000, Oxford: Update Software.
4. Koren G, Bishai R Nausea and Vomiting of Pregnancy: State of the Art 2000 (Vol.1). Motherisk 2000, The Hospital for Sick Children, Toronto, Canada, pp.12-200).
5. Lacroix R, Eason E, Melzack R Nausea and vomiting during pregnancy: A prospective study of its frequency, intensity, and patterns of change. American Journal of Obstetrics and Gynecology 2000, 182 (4), pp. 931-7.
6. Murphy P.A. Alternative therapies for nausea and vomiting of pregnancy. Obstetrics and Gynecology 1998, 91(1), pp.149-55.
7. Sears W, Sears M The Pregnancy Book. Little, Brown and Company, USA 1997.
8. Varney H Varney’s Midwifery (3ed). Jones & Bartett Publishers, Sudbury MA 1997.

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